TY - JOUR
T1 - Predictors, burden and impact of cardiac arrhythmias among patients hospitalized with end-stage liver disease
AU - Adejumo, Adeyinka Charles
AU - Adejumo, Kelechi Lauretta
AU - Akanbi, Olalekan
AU - Adegbala, Oluwole Muyiwa
AU - Alayo, Quazim Adegbola
AU - Fijabi, Daniel Obadare
AU - Ogundipe, Olumuyiwa Akinbolaji
AU - Almaddah, Nureddin
AU - Pani, Lydie
AU - Adeboye, Adedayo
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Cirrhotic cardiomyopathy, hyperammonemia, and hepatorenal syndrome predispose to cardiac arrhythmias in End-stage liver disease (ESLD). Objectives: Among ESLD hospitalizations, we evaluate the distribution and predictors of arrhythmias and their impact on hospitalization outcomes. Methods: We selected ESLD records from the Nationwide Inpatient Sample (2007–2014), identified concomitant arrhythmias (tachyarrhythmias and bradyarrhythmias), and their demographic and comorbid characteristics, and estimated the effect of arrhythmia on outcomes (SAS 9.4). Results: Of 57,119 ESLD hospitalizations, 6,615 had arrhythmias with higher odds with increasing age, males, jaundice, hepatorenal syndrome, alcohol use, and cardiopulmonary disorders. The most common arrhythmias were atrial fibrillation, cardiac arrest/asystole, and ventricular tachycardia. After propensity-matching (arrhythmia: no-arrhythmia, 6,609:6,609), arrhythmias were associated with 200% higher mortality, 1.7-days longer stay, $32,880 higher cost, and higher rates of shock, respiratory and kidney failures. Conclusions: Due to worse outcomes with arrhythmias, there is a need for better screening and follow-up of ESLD patients for dysrhythmias.
AB - Background: Cirrhotic cardiomyopathy, hyperammonemia, and hepatorenal syndrome predispose to cardiac arrhythmias in End-stage liver disease (ESLD). Objectives: Among ESLD hospitalizations, we evaluate the distribution and predictors of arrhythmias and their impact on hospitalization outcomes. Methods: We selected ESLD records from the Nationwide Inpatient Sample (2007–2014), identified concomitant arrhythmias (tachyarrhythmias and bradyarrhythmias), and their demographic and comorbid characteristics, and estimated the effect of arrhythmia on outcomes (SAS 9.4). Results: Of 57,119 ESLD hospitalizations, 6,615 had arrhythmias with higher odds with increasing age, males, jaundice, hepatorenal syndrome, alcohol use, and cardiopulmonary disorders. The most common arrhythmias were atrial fibrillation, cardiac arrest/asystole, and ventricular tachycardia. After propensity-matching (arrhythmia: no-arrhythmia, 6,609:6,609), arrhythmias were associated with 200% higher mortality, 1.7-days longer stay, $32,880 higher cost, and higher rates of shock, respiratory and kidney failures. Conclusions: Due to worse outcomes with arrhythmias, there is a need for better screening and follow-up of ESLD patients for dysrhythmias.
KW - Atrial fibrillation
KW - Cardiac arrest
KW - Cost
KW - Length of stay
KW - Mortality
KW - Ventricular tachycardia
UR - https://www.scopus.com/pages/publications/85068830636
U2 - 10.1016/j.hrtlng.2019.07.002
DO - 10.1016/j.hrtlng.2019.07.002
M3 - Article
C2 - 31320178
AN - SCOPUS:85068830636
SN - 0147-9563
VL - 49
SP - 73
EP - 79
JO - Heart and Lung
JF - Heart and Lung
IS - 1
ER -